Page 291 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology Preperitoneal infiltration after laparoscopic cholecystectomy

intra-abdominal cavity elongation, amount of blood that originate from the abdominal wall. A prolonged
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left in the abdomen, and pelvic region dissection, may hospital stay, myocardial ischemia, delirium, respiratory
induce distinct types of pain. Furthermore, patients who complications, and an elevated probability of chronic
2
underwent laparoscopic procedures, which are renowned pain are among the numerous undesirable post-operative
for their reduced pain, were found to experience excessive consequences that may result from poorly controlled
post-operative pain and receive inadequate pain alleviation pain following abdominal surgery, in addition to patient
in comparison to aggressive major operations. Despite suffering and distress. 14
9,11
the procedure’s minimal invasive nature, the post- Advantages of effective post-operative analgesia include
operative pain that follows laparoscopic cholecystectomy
is frequently difficult to manage, leading to delayed reduced post-operative morbidity and stress response,
hospital discharge and increased opioid use. In addition, increased patient satisfaction, and enhanced patient
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patients who undergo abdominal interventions experience outcome.
significant distress that is linked to somatic pain signals In this investigation, 40 patients were scheduled
for laparoscopic cholecystectomy surgery and were
Table 4. Comparison of post‑operative nausea and vomiting categorized into two groups. The preperitoneal group
between groups (n = 20) underwent trocar infiltration of local anesthetic,
Presence of TAP block Preperitoneal Test p‑value while the TAP block group (n = 20) was given a TAP block
post‑operative group group value under ultrasound guidance.
nausea and vomiting (n=20) (%) (n=20) (%) Our findings show no significant difference in sleep
No 8 (40.0) 10 (50.0) 0.404 0.525 quality between the TAP block and preperitoneal groups.
Yes 12 (60.0) 10 (50.0) Moreover, regarding VAS and the first request of analgesia,
Note: Chi-square test for number (%) or Fisher’s exact test, when the results showed that the 8- and 12-h VAS scores had a
appropriate. higher median value in the preperitoneal group than the
Abbreviation: TAP: Transversus abdominis plane.
TAP block group, with a statistically significant difference.
Table 5. Comparison of time to first request for rescue The parameters were insignificant at 0-, 2-, and 4-h.
analgesia between groups This study compared the analgesic efficacy of the TAP
block and preperitoneal infiltration with bupivacaine
Group Time to first request for Test p‑value
rescue analgesia (hours) value in patients undergoing laparoscopic cholecystectomy.
TAP block group 12–18 (14.60±2.52) 5.027 0.001* The findings demonstrated that the TAP block provided
Preperitoneal group 6–8 (7.10±1.02) superior pain relief, as evidenced by significantly lower
VAS scores at 8- and 12-h post-operation and a longer
Note: Data presented as range (mean±standard deviation), unless time to first rescue analgesia (14.6±2.52 h in the TAP block
stated otherwise. Independent sample t-test for mean±standard
deviation.* indicates statistical significance. group vs. 7.1 ± 1.02 h in the preperitoneal group, p<0.001).
Abbreviation: TAP: Transversus abdominis plane. In addition, patients in the TAP block group required

Table 6. Opioid requirements and dosage among the studied groups
Opioid TAP block group Preperitoneal p‑value Effect size, relative risk
requirement (n=20) (%) group (n=20) (%) (95% confidence interval)
Required 2 (10.0) 5 (25.0) 0.037* 0.51 (0.23–1.09)
Not required 18 (90.0) 15 (75.0)
Note: Effect size refers to the effect of the TAP block group relative to the preperitoneal group. *indicates statistical significance.
Abbreviation: TAP: Transversus abdominis plane.

Table 7. Opioid total dose in cases that required analgesia among the studied groups

Group Opioid total dose (mg) p‑value Effect size, mean±standard error (95% confidence interval)
TAP block group (n=2) 50.0–75.0 (55.0±11.2) 0.007* −27.7±9.0 (−46.9–−8.5)
Preperitoneal group (n=5) 50.0–100.0 (82.7±18.8)
Note: Statistical analysis using an independent t-test. Effect size refers to the effect of the TAP block group relative to the control. *indicates statistical
significance.
Abbreviation: TAP: Transversus abdominis plane.

Volume 9 Issue 3 (2025) 283 doi: 10.36922/EJMO025180164